Electroconvulsive Therapy is Effective, Overlooked Mental Health Treatment

For many, the phrase “electroconvulsive therapy” (ECT) may conjure negative images. The idea of receiving electric shocks, even as part of a medical treatment, is not particularly appealing.

However, there is quite a gap between what people believe ECT to be, and what it actually is. For decades, ECT has been a viable option to address treatment-resistant depression and other similar disorders.

Just ask Emma Beal. Emma is 27 years old, a lifelong Lincolnite who has bipolar disorder. She has struggled throughout her life with suicidal thoughts, being hospitalized at Bryan Medical Center multiple times after various mental health crises.

After one particularly intense episode earlier this year, Dr. Bill Michael recommended ECT. A few months later, her quality of life has increased dramatically.

Treatment Begins

When Dr. Michael, a board-certified psychiatrist for almost 25 years, first mentioned ECT, Emma was unsure.

“My perception of it ahead of time was the unknown,” she said. “I didn’t know anything about it, but I was at such a low point in my journey that I was ready to try anything."

Emma began treatment in February at Bryan West Campus, the only place in Lincoln that offers ECT. Dr. Michael and Dr. Jose Gary Nadala are the two psychiatrists at Bryan Health who are certified to administer ECT.

Dr. Michael said ECT is typically divided into three phases: acute, continuation and maintenance. If successful, the depressive symptoms will be in remission after the acute phase.

Continuation and maintenance phases are designed to prevent the return of these symptoms. The lengths of these phases vary patient-to-patient.

The first one or two sessions are inpatient to make sure the patient has no adverse reactions. Then, treatment shifts to outpatient.

Emma underwent therapy in the mornings. Each treatment is quick. Emma would get a brief examination followed by IV insertion. She was put under general anesthesia, and then Dr. Michael would administer the treatment.

“You’re in and out of there, but they never make you feel rushed,” she said.

During the procedure, small electrical currents are passed through the brain to intentionally trigger a small – and safe – seizure. The treatment causes changes in brain chemistry that can improve depressive symptoms.

On treatment days, Emma wouldn’t do much else due to fatigue. She said she felt sore – like she had worked out – and had some mental confusion. But the benefits far outweighed any side effects.

Once she had a few sessions, she noticed subtle positive changes in her daily mental health. She started waking up with a clearer head and felt calmer. She was able to focus better and be more appreciative of life.

“I know that sounds cheesy, but it’s true,” Emma said. “As somebody who has suffered with my mental health for a long time, it’s worked so well for me.”

Fighting the Stigma

When ECT was first practiced over 80 years ago, patients were in much more discomfort, Dr. Michael said. The treatment did not include anesthesia; patients were completely aware the entire time. It was, to put it lightly, a traumatic experience.

But now, ECT is different. Patients are under general anesthesia for the entire procedure. An anesthesia provider is with them the entire time, and treatment is tailored to each patient’s needs.

Dr. Michael said the stigma around ECT developed from how it was done decades ago. When people hear the words “electroconvulsive therapy,” they may think of imagery from movies and TV shows. This stigma “really does a disservice” to people who would benefit from treatment if they weren’t fearful of it.

To break this stigma, Dr. Michael said the word about ECT’s benefits must be spread.

“As with a lot of things in psychiatry, it comes down to education, education, education,” he said. “We have to convey it to patients in a way that is as objective as possible to combat that stigma.”

In addition to removing any unfounded fears about ECT, Dr. Michael said people should also know that the treatment is highly effective. Dr. Michael said that ECT’s 80-85% remission rate is the highest for any treatment.

A New Outlook

Emma started therapy in February and finished in May. The number of sessions a patient needs after the acute phase is determined by subjective and objective benchmarks.

“If I were to give any advice for people at the beginning of ECT, it would be to just buckle down through those first two weeks,” Emma said. “They’re tough, and it’s tiring.”

Now that her treatment is complete, Emma said she’s so grateful for everybody who helped her through ECT, including Dr. Michael, the nurses in the clinic and her mom. From here, Emma will continue seeing her outpatient psychiatrist and therapist regularly for mental maintenance.

At her lowest point, Emma had lost interest in many of her favorite activities, such as baking, gardening and listening to music. Thanks to ECT, her love for life has returned.

“I would say it's not as scary or intimidating as it seems,” she said. “It's actually really comfortable and totally normal. The worst part is getting your IV and then you don't feel anything else. As long as you’re ok with a little poke, then you should be fine. It’s worth it.”

Learn More about ECT

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